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P138. Severe disease activity and cytomegalovirus colitis are associated with an increased risk of venous thromboembolism in patients with inflammatory bowel disease

K.-J. Kim, H.-S. Lee, S.H. Park, B.D. Ye, D.-H. Yang, K.W. Jung, J.-S. Byeon, S.-J. Myung, S.-K. Yang, J.-H. Kim, S.-M. Hong, Asan Medical Center, Gastroenterology, Seoul, Korea, Republic of

Background

There is still a paucity of data on venous thromboembolism (VTE) in Asian populations. Here, we evaluate the incidence and risk factors of VTE in patients with inflammatory bowel disease (IBD).

Methods

We compared Korean patients with VTE and IBD to matched IBD controls without VTE. In addition, we investigated the association between VTE and cytomegalovirus (CMV) colitis in patients who provided colonic tissue samples between July 1989 and January 2013.

Results

Of 4467 patients diagnosed with IBD at our center, 26 patients with VTE were identified, including 12 with Crohn's disease (CD) and 14 with ulcerative colitis (UC). The incidence of VTE was 0.58%. The recent use of steroids (OR = 7.00; 95% CI = 1.59–30.77; p = 0.010) and elevated C-reactive protein (CRP) (OR = 1.17; 95% CI = 1.00–1.37; p = 0.046) were associated with an increased risk of developing VTE. Moreover, each 1% rise in hematocrit decreased the risk of VTE by 14% (OR = 0.86; 95% CI = 0.77–0.97; p = 0.015).

According to our second analysis, CMV colitis is associated with an increased risk of developing VTE (OR = 4.01; 95% CI = 1.49–10.78; p = 0.006). Both hospitalization and bowel resection were more common in patients with than without VTE during the follow-up period. None of our VTE patients died.

Conclusion

The incidence of VTE seems to be lower in Asian than in Western patients. Higher disease activity is associated with an increased risk of developing VTE and CMV colitis may also increase this risk. IBD patients with CMV colitis and higher disease activity may require vigilant observation to diagnose VTE. We strongly support the use of prophylactic anticoagulation during hospitalization in affected patients.